AKI in Hospitalized Patients with COVID-19
Open accessPublished version of a preprint
Abstract
Significance Statement: Early reports have indicated that AKI and other kidney abnormalities are associated with coronavirus disease 2019 (COVID-19). Of 3993 hospitalized patients with COVID-19 in a New York City health system, AKI occurred in 1835 (46%) patients; among patients with AKI, 19% required dialysis, and half of them died in the hospital. Among patients who were discharged, 35% had not recovered to baseline kidney function at the time of discharge. AKI is common among patients with COVID-19 and is associated with higher mortality than in patients without AKI; among those who survive, only about a third are discharged with renal recovery. These findings may help centers with resource planning and preparing for the increased load resulting from survivors of COVID-19–associated AKI who do not experience recovery of kidney function. Background: Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 in the United States is not well described. Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged ≥18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results: Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions: AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.
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A number of clinical symptoms are observed in COVID-19 patients hospitalized with Acute Kidney Injury (AKI).
“A number of clinical symptoms are observed in COVID- 19 patients hospitalized with Acute Kidney Injury (AKI) [83–86].”
From A comprehensive survey on federated learning techniques for healthcare informatics (2023) · cites this paper as [86]
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- Authors
- Chan, L., Chaudhary, K., Saha, A., Chauhan, K., Vaid, A., Zhao, S., Paranjpe, I., Somani, S., Richter, F., Miotto, R., Lala, A., Kia, A., Timsina, P., Li, L., Freeman, R., Chen, R., Narula, J., Just, A. C., Horowitz, C., Fayad, Z., Cordon-Cardo, C., Schadt, E., Levin, M. A., Reich, D. L., Fuster, V., Murphy, B., He, J. C., Charney, A. W., Böttinger, E. P., Glicksberg, B. S., Coca, S. G., Nadkarni, G. N., & on behalf of the Mount Sinai COVID Informatics Center (MSCIC)
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Hasso Plattner Institute (DE)
- Corresponding author
- Nadkarni, Girish N.
- ORCID
- Chan, Lili
- Chaudhary, Kumardeep
- Saha, Aparna
- Chauhan, Kinsuk
- Vaid, Akhil
- Zhao, Shan
- Paranjpe, Ishan
- Somani, Sulaiman
- Miotto, Riccardo
- Kia, Arash
- Timsina, Prem
- Li, Li
- Freeman, Robert
- Chen, Rong
- Narula, Jagat
- Just, Allan C.
- Fayad, Zahi
- Levin, Matthew A.
- Charney, Alexander W.
- Böttinger, Erwin P.
- Glicksberg, Benjamin S.
- Coca, Steven G.
- Nadkarni, Girish N.
- Venue
- Journal of the American Society of Nephrology
- Published
- 2020-09-03
- Volume
- 32
- Issue
- 1
- Pages
- 151-160
- ISSN
- 1046-6673 (ISSN-L)
- 1533-3450
- PMC
- PMC7274245
- OpenAlex
- W3082170884
- Cited by
- 805
- References
- 28
- Citations by year
- 2026: 20 · 2025: 58 · 2024: 88 · 2023: 151 · 2022: 218 · 2021: 214 · 2020: 55
- FWCI
- 100.59
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of the American Society of Nephrology (publishedVersion)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- publish.UP (University of Potsdam) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL085757)
- National Human Genome Research Institute (U01HG007278)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK112258, U01DK106962, K23DK107908, R01DK115562, U01DK116100, R01DK108803)
- National Institute for Occupational Safety and Health (U01 OH011326)
- Topics
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- acute kidney injury, COVID-19 pandemic, hospitalized patients, dialysis requirement, in-hospital mortality, renal function recovery, proteinuria, hematuria, pyuria, chronic kidney disease, serum potassium, intensive care unit admission, hospital resource planning, Mount Sinai Health System, SARS-CoV-2
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